Provider Demographics
NPI:1609319250
Name:STEP BY STEP PEDIATRIC THERAPY
Entity Type:Organization
Organization Name:STEP BY STEP PEDIATRIC THERAPY
Other - Org Name:MANDY L SANGHA
Other - Org Type:Other Name
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MANDY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:SANGHA
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:720-453-0733
Mailing Address - Street 1:1096 MILO CIR UNIT A
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-3084
Mailing Address - Country:US
Mailing Address - Phone:720-453-0733
Mailing Address - Fax:720-360-0624
Practice Address - Street 1:1096 MILO CIR UNIT A
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-3084
Practice Address - Country:US
Practice Address - Phone:312-835-6665
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-30
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
No252Y00000XAgenciesEarly Intervention Provider AgencyGroup - Single Specialty